中医体质与终末期肾病透析患者不安腿综合征发生的相关性分析

Analysis of the correlation between Chinese medicine constitution and the occurrence of restless legs syndrome in dialysis patients with end-stage renal disease

关键词:  终末期肾病  不安腿综合征  体质  匹兹堡睡眠指数评分

Key words:  end-stage renal disease  restless legs syndrome  constitution  Pittsburgh Sleep Quality Index

摘要:

[目的] 探讨终末期肾病（ESRD）透析患者发生不安腿综合征（RLS）的危险因素及体质分布特征。[方法] 通过门诊调查问卷方式，调查194例血液透析及242例腹膜透析患者RLS发生情况及匹兹堡睡眠指数（PSQI）评分，同时收集患者实验室数据，并根据《中医体质分类与判定表》对全部患者的体质进行判定。分析终末期肾病透析患者中医体质分布及发生RLS的临床危险因素。[结果] 全部患者中体质分布主要为平和质（23.17%）、阴虚质（23.17%）、阳虚质（19.27%）及痰湿质（16.51%）。血液透析患者占比最高的偏颇体质为阴虚质（25.26%），腹膜透析患者占比最高的偏颇体质亦为阴虚质（21.49%），存在RLS的患者中以阴虚质（28.57%）及阳虚质（23.15%）占比最高。经多因素逻辑回归分析，较长的透析龄、较低的血红蛋白水平及较高的血磷水平为透析患者发生RLS的危险因素。与平和体质的患者相比，阴虚体质与阳虚体质患者更易发生RLS。RLS的发生与睡眠质量下降具有相关性。[结论] 终末期肾病透析患者具有一定的体质分布特征，除临床相关危险因素外，阴虚体质与阳虚体质患者更易发生RLS，临床需给予重点关注及调理。

Abstract:

[Objective] To investigate the risk factors and constitution distribution characteristics of restless legs syndrome（RLS） in end-stage renal disease（ESRD） patients undergoing hemodialysis and peritoneal dialysis. [Methods] A questionnaire survey was conducted among 194 hemodialysis patients and 242 peritoneal dialysis patients to assess the occurrence of RLS and Pittsburgh Sleep Quality Index（PSQI） scores. Laboratory data were collected，and the constitution of all patients was classified according to the “Classification and determination of traditional Chinese medicine constitution table”. The distribution of traditional Chinese medicine constitutions and risk factors for RLS in ESRD dialysis patients were analyzed. [Results] The primary constitutions among all patients were balanced constitution（23.17%），yin deficiency constitution（23.17%），yang deficiency constitution（19.27%），and phlegm-dampness constitution（16.51%）. Among hemodialysis patients，the most common imbalanced constitution was yin deficiency（25.26%），while among peritoneal dialysis patients，it was also yin deficiency（21.49%）. In patients with RLS，yin deficiency（28.57%） and yang deficiency（23.15%） constitutions were the most prevalent. Multivariate logistic regression analysis revealed that longer dialysis duration，lower hemoglobin levels，and higher blood phosphorus levels were risk factors for RLS in dialysis patients. Compared to patients with a balanced constitution，those with yin deficiency and yang deficiency constitutions were more prone to RLS. The occurrence of RLS was correlated with decreased sleep quality.[Conclusion] ESRD patients undergoing dialysis exhibit specific constitution distribution characteristics. In addition to clinical risk factors，patients with yin deficiency and yang deficiency constitutions are more susceptible to RLS，warranting special attention and regulation in clinical practice.